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	<title>SAER</title>
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			<h1>
				<a>SAER</a>
			</h1>
			<form id="form_492649" class="appnitro" enctype="multipart/form-data" method="post" action="">
				<div class="form_description">
					<h2>Sistema de Asistencia Emergentológica Remota(SAER)</h2>
					<p>Investigación en Ingeniería de Software.</p>
				</div>
				<ul>
					<li class="section_break">
						<h3>DATOS ENFERMERO</h3>
					</li>
					<li id="li_1">
					<span>
						<label class="description" for="element_1">ID</label>
						<div>
							<input id="element_1" name="element_1" class="element text small"	type="text" maxlength="255" value="" />
						</div>
					</span>
					<span>
						<label class="description" for="element_2">Nombre y Apellido </label>
					<span> 
						<input id="element_2_2" name="element_2_2" class="element text" maxlength="255" size="60" value="" />
					</span>
					</span>
					<span>
						
					</span>
					</li>
					<li id="li_3"><label class="description" for="element_3">Email
					</label>
						<div>
							<input id="element_3" name="element_3"
								class="element text medium" type="text" maxlength="255" value="" />
						</div></li>
					<li class="section_break">
						<h3>DATOS PACIENTE</h3>
					</li>
					<li id="li_4">
					<span>
					<label class="description" for="element_4" >DNI
					</label>
						<div>
							<input id="element_4" name="element_4" 	class="element text medium" type="text" maxlength="255"  size="40" value="" />
						</div>
					</span>
					<span>
						<label class="description" for="element_2">Nombre y Apellido </label>
					<span> 
						<input id="element_2_2" name="element_2_2" class="element text" maxlength="255" size="60" value="" />
					</span>
					</span>
					</li>
					<li id="li_6"><label class="description" for="element_6">Domicilio
					</label>
						<div>
							<input id="element_6_1" name="element_6_1"
								class="element text large" value="" type="text">
						</div>
						</li>
					<li id="li_14"><label class="description" for="element_14">SEXO
					</label>
						<div>
							<select class="element select medium" id="element_14"
								name="element_14">
								<option value="" selected="selected"></option>
								<option value="1">FEMENINO</option>
								<option value="2">MASCULINO</option>
							</select>
						</div></li>
					<li id="li_9"><label class="description" for="element_9">EDAD
					</label>
						<div>
							<input id="element_9" name="element_9" class="element text small"
								type="text" maxlength="3"  size="10" value="" />
						</div></li>
					<li class="section_break">
						<h3>DATOS ELECTROCARDIOGRAMA</h3>
					</li>
					<li id="li_11"><label class="description" for="element_11">Cargar
					</label>
						<div>
							<input id="element_11" name="element_11" class="element file"
								type="file" />
						</div></li>
					<li id="li_12"><label class="description" for="element_12">FECHA
					</label> <span> <input id="element_12_1" name="element_12_1"
							class="element text" size="2" maxlength="2" value="" type="text">
								/ <label for="element_12_1">DD</label></span> <span> <input
							id="element_12_2" name="element_12_2" class="element text"
							size="2" maxlength="2" value="" type="text"> / <label
								for="element_12_2">MM</label></span> <span> <input
							id="element_12_3" name="element_12_3" class="element text"
							size="4" maxlength="4" value="" type="text"> <label
								for="element_12_3">YYYY</label></span> <span id="calendar_12"> <img
							id="cal_img_12" class="datepicker" src="../imagenes/calendar.gif"
							alt="Pick a date."></span> <script type="text/javascript">
								Calendar.setup({
									inputField : "element_12_3",
									baseField : "element_12",
									displayArea : "calendar_12",
									button : "cal_img_12",
									ifFormat : "%B %e, %Y",
									onSelect : selectEuropeDate
								});
							</script></li>
					<li class="section_break">
						<h3>DATOS CLINICOS</h3>
						<p></p>
					</li>
					<li class="form-line" id="id_1"><label class="form-label-left"
						id="label_1" for="input_1"> Temperatura Corporal </label>
						<div id="cid_1" class="form-input">
							<input type="number" id="input_1" name="q1_temperaturaCorporal" />
						</div></li>
					<li class="form-line" id="id_3"><label class="form-label-left"
						id="label_3" for="input_3"> Sistólica </label>
						<div id="cid_3" class="form-input">
							<input type="number" id="input_3" name="q3_sistolica" />
						</div></li>
					<li class="form-line" id="id_4"><label class="form-label-left"
						id="label_4" for="input_4"> Diastólica </label>
						<div id="cid_4" class="form-input">
							<input type="number" id="input_4" name="q4_diastolica" />
						</div></li>
					<li class="form-line" id="id_5"><label class="form-label-left"
						id="label_5" for="input_5"> Frecuencia Respiratoria </label>
						<div id="cid_5" class="form-input">
							<input type="number" id="input_5"
								name="q5_frecuenciaRespiratoria" />
						</div></li>
					<li class="form-line" id="id_8"><label class="form-label-left"
						id="label_8" for="input_8"> pulsaciones por minuto </label>
						<div id="cid_8" class="form-input">
							<input type="number" id="input_8" name="q8_pulsacionesPor" />
						</div></li>
					<li class="form-line" id="id_6"><label class="form-label-left"
						id="label_6" for="input_6"> glucosa en sangre </label>
						<div id="cid_6" class="form-input">
							<input type="number" id="input_6" name="q6_glucosaEn" />
						</div></li>
					<li class="form-line" id="id_7"><label class="form-label-left"
						id="label_7" for="input_7"> oxigeno en sangre </label>
						<div id="cid_7" class="form-input">
							<input type="number" id="input_7" name="q7_oxigenoEn" />
						</div></li>


					<li class="buttons"><input type="hidden" name="form_id"
						value="492649" /> <input id="saveForm" class="button_text"
						type="submit" name="submit" value="Enviar" /></li>
				</ul>
			</form>
		</div>
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